Pessary and manipulating handle assembly



s. 1.. DE BRAY ETAL 2,452,229 PESSARY MANIPULATING' HANDLE ASSEMBLY Oct. 26, 1948.

Filed March 18, 1946- Fffi j.

M a 3 MM w 00 z N F FLU 5 1 F 2 iNVENTOR.

Patented Oct. 26, 1948 PESSARY AND MANIPULATING HANDLE ASSEMBLY Glenn L. De Bray and Atwill Morgan, Los Angeles, Calif.

Application March 18, 1946 Serial No. 655,109 Claims. (01. 128-127) This invention relates to pessaries and has par:

ticular reference to a pessaryand manipulating handle assembly especially adapted for the treat-- ment of uterine prolapse, in which the pessary is required to remain within the vaginal cavity over relatively long periods of time.

In the treatment of uterine prolapse, it is frequently desirable to provide an artificial support for the uterus which will hold the uterus in its, normally retracted position for a sufiiciently long period of time to permit restoration of the muscles to a condition in which they can naturally support the uterus.

In other instances it is found that it is necessary to maintain the artificial support for an invide the necessary normal support.

In the treatment of such cases, ithas heretofore beenthe practice to utilize a pessary adapted to be inserted into the vaginal cavity a sufiicient distance to engage the exposed end of the uterus,

the pessary then being pressed upwardly to position the uterus in its normal position, the pessary remaining in this position, engaging the vaginal pulled downwardly out of its normal position by its adhesion to the surfaces of the pessary.

In order to permit removal and readjustment of the pessary, it is, therefore, desirable to insure severance of any adhesion between the pessary and the uterus prior to the exertion of any outward pull on the pessary. In addition, it frequently occurs that the accumulationnof body;

secretions" above the pessary is of such volume as to require frequent irrigation, which is difficult, if not impossible, with known types of pessaries employed for this purpose. A

l It is, therefore, an objectof this invention to definite period of time where the muscular development and restoration are insufficient to pro- "provide a pessary of the character described,

which may be readily inserted and removed, and which is provided with a positive means for separating the pessary from the tissues engaged thereby prior to the exertion of any outward P on the pessary,

Another object of this invention is to provide a pessary of the character described, wherein the body of the pessary is provided with an irriga- ;.tion opening, through which irrigation fluids may readily be passed from the exterior of the body to the portions of the pessary engaging the surrounding body tissues.

Another object of this invention is to provide a pessary of the character described, in which the irrigation opening is normally closed by means of an outwardly movable valve, and in which means is provided for positively opening the valve in order to insure the breaking of any adhesion between the outer end of the uterus and the adjacent surfaces of the body of the pessary.

Another object of this invention is to provide a pessary of the character described in the precedin paragraph, in which in addition to the manipulation of the valve to open and close the irrigation opening through the body of the pessaryfthe valve is adapted to be rotated relative to the body to insure the breaking of any adhesion between the surface of the valve and the adjacent surfaces of the body tissues.

Another object of this invention is to provide a pessary of the character described in the preceding paragraph, in which the valve when moved from a closed to open position may be substantially locked in the open position to permit irrigation either by continuous flow through the body or by alternate injection and removal of irrigation fluids through the same opening in the pessary body.

Other objects and advantages of this invention will be apparent from a study of the following specifications read in connection with the accompanying drawings wherein:

Fig. 1 is a vertical sectional view throu h apessary constructed in accordance with this invention and illustrating the manner in which a manipulating handle may be adapted thereto;

Fig. 2 is a view similar to Fig. 1 but illustrating the handle in section and illustrating the posi- 3 tion of the pessary parts when the parts are in position for irrigation;

Fig. 3 is a top plan view of the pessary body with the valve removed; and

Fig. 4 is a detailed fragmentary sectional view taken along line IVIV of Fig. 2.

Referring to the drawings herein, there is illus-' trated in Fig. 1 a pessary body I which is preferably constructed as a substantially large diameter cup portion 2, from which extends a downwardly depending stem 3.

The cup portion-.2 isof suflicienttdiameter to,

spread the walls offlthe vagina as the body isinserted therein, the surrounding vaginal' walls tending to hold the body in place against the protruding end of the uterus and to hold the uterus in its retracted position: against accidental:

prolapse.

The upper surface of the cup portionlisconcaved, as illustrated in Fig. 1, to conform with the convexity of the protruding end of the uterus,

and is preferably polished topresentf-a 'smooth non-irritating surface to the engaged tissues.

The stem 3 is preferably cylindrical and of sufficient extent to provide a relatively great area of contactwith; the surrounding vaginal walls to provides: further-support forholding the-pessary inthe retracted {position- I i The stem 3 is provided-with acentral axial bore 4 communicating with theconcaved inner surface of the cup 2 and with the outer end of the stem to providea guides'for the stemfi of-a valve 1'6. which. isadaptedto close upon'a conical.

The-stem ;5 of theavalva ispreferably. sufficiently, long to extend into a counterbore 9 formed. in the lower endpf. the body stem -3,. the counter; boreTS- being of: considerably greater diameter thanthatofthe guide bore whilethe guide bore 4 is providedwith one ormoregr'ooves Occhannels l-fl.extendingthroughout the length of the .boretqprovideone ormore fluid passages past. the valvestemiti.

The' lower]. end. of. the valve stemAB is. provided with..couplingQmeans-such as threads; U adapted to be. engagedgby a complementary coupling l2 formed upon and-constituting a part'of a manipulating handle, l3 ,byiwhich the pessary and valve assemblymay bei'inserted' into or removed from its positionwithin the"vaginal ,cavity and by whichirrigation through the pessary andvalve assembly may beobtained. v v

The handle [3 is preferably constructed as an elongatedtubular member having'a. bore 84 ex-' tending' from its. lower" end. to a position immediately below the couplin 1Z1 thebore M constituting a fluid passage which communicates.

witlr'the space within-the counter bore"'9; as by means ofa plurality of angularly extendin'g'ports I5: The ports 15' are preferably formed with their outer endsimmediately adjacent the couplinglZ; the ports being-formed through an enlargement I8 of the tubular handle member 13, the upper surface of which enlargement is preferablytapered'as indicated at H, toseat against acorrespondingly tapered surface 18 formed at the lower end of the body stem 3i I By referring particularlyto =Fig. 2, it will"be observed that when the handlemember "I3. i

4 pressed upwardly toward the outer end of the body stem 3, the meeting of tapered surfaces IT and 18 will form a substantial seal, such that irrigation fluids passing through the handle bore Hi will readily pass into the counter bore 9 and upwardly through the grooves or channels ill to the upper side of the cup 2, while escape of such fluids at the junction of the enlargement l6 and the end of the stem 3 will be prevented.

It will be observed also that the coupling member l2 extends above the enlargement 16 a sufficient distance that whenthe. coupling. l2.is engaged' with the threads or other coupling means II on the valve stem 5 and the handle member l3iis moved upwardly to engage the tapered surfaces H and I8, the valve 6 will be positively lifte'dfrorn its seating relation upon the seat 1.

Hence, the manipulating handle I3 provides a positive means by whichthe valve 6 may be moved to its open position with positive assurance that the valve will so move and separate the con ti'guous concaved surfaces of the cup and valve.

Withv the construction thus far described, it will'be apparent that the assembled body and valve may be readily engaged with a manipulatingihandleg -and 5 the handle is then used for insertion of the pessary'into: its proper position to retract the uterus" and to position the body in aposition to: hold the uterus in its retracted 1ocanon: Further, the handle l3- being positively engaged with the valve Gmay be'utilized todraw the valve downwardly into its closed-position without imposing any substantial outwardly directed forcesupon the body; After the body and valve have been properly positioned, rotationalmovement or the handle willl disconnect the'handle from the valve and permit removal of the handle, leaving the pessary assembly in place.

Th handle 'may be reinserted and re-engaged with the--valveb'y inserting and rotating the handle'me mber 'and afterthe-handle has been recou'pl'e'd totheyalve -an inward movement of the handle will cause a positive movement of the valve' from*its closedto its open position.

To facilitate the disengagement of the handle from-the valvestem 5*and its 're-engagement therewith-by a rotary'mo'vement, we prefer to provide' the valve stem 5 with a projecting lug l9 adapted to extend radially into'one of the; chemremoval of the pessary' with absolute assurance 7 Valve in-place-within the cavity.

nels or grooves I I! to prevent rotary movement between the valve stem 5' and the body stem 3 while permitting ready axial sliding movement between these members.

Withthe'construction thus far described it will beapparent that whenever the'handle is engaged with- 'the valve, the engagement is a positive one,

which will permit the-movement of the valve to open-'and'closed positions and will permit the tha't' thevalve 6' will be removed with the body. Thus; there is no dangerof accidental disengagement "of-the valve with the body orthe possibility of'removing the body while leaving the Entirely aside from the use of'the handle and valve-for irrigation purposes, as will be hereinafter-more fully-described, thepositive engage m'ent between the han'dle and the valve permits the manipulation of thevalve to retract the central portionsof the end of the uterus from surfacecontact with the'concaved inner'surface of the body cupand 'thu's tend to bre'ak anyadhesion' -between the uterus-and the. surface of the cup, while arotat'io'n'al movementimay'beimpartedto the" valve-whichwill also tendto break any adhesion between the valve and contacting surface-tissues. Thus, irrespective of whether or not irrigation fluids are employed, a positive release of the pessary from the contacting tissues may be accomplished prior to the withdrawal of the pessary from its innermost position within the cavity.

By referring particularly to Fig. 2, it will be observed that the outer end of the handle member I3 is provided with attachment mechanism, such as threads 28, by which a suitable syringe may be connected to the handle for irrigating the cavity when the handle member is attached .to the pessary unit, and to insure that the fluid passage will remain open during the period of irrigation, we prefer to provide a counterbore 2| at the upper end of the guide bore 4 t provide shoulders 22 against which the lug I9 on the valve stem 5 may rest after the valve has been moved to its open position and rotated through a partial revolution to dispose the lug l9 at a position intermediate adjacent channels l0. Thus the valve is locked in its open position until a rotational movement is imparted to the handle l3 to realign the lug 19 with one of the channels to permit the retraction of the valve 6 back toward its closed position.

If desired, the extreme lower end of the handle member l3 may be tapered, as indicated at 23, to receive the tapered end of a syringe or other device through which the irrigation fluid is to be passed into and through the handle.

It will be apparent from the foregoing that we have provided a pessary which may be inserted and left in position over an indefinite length of time, but which may be readily removed at any time by the insertion of the handle member 13 and its coupling with the valve stem 5.

It will also be noted that by employing the construction described herein, not only is there a positive breaking of any adhesion between the body tissues and the pessary by mechanical manipulation of the valve 6, but the construction permits of the ready employment of irrigation fluids to further release any adhesion which might occur.

It will also be apparent that the manipulation of the valve 6 by means of the handle l3 permits the ready irrigation of the cavity without requiring the removal of the pessary, with the result that the pessary may remain in the cavity for appreciably greater lengths of time than is possible with the existing types of devices.

While there has been shown and described the preferred embodiment of the present invention, the same is not to be limited to any of the details of construction shown or described herein, except as defined in the appended claims.

What is claimed as new is:

l. A pessary, comprising a unit including a body member having a concave tissue engaging depression in one of its surf-aces, a valve bore extending through said body and communicating with said concave surface and having a valve seat formed therein adjacent said surface, a valve member having a stem extending through said bore and adapted to seat upon said valve seat, the surface of said valve exposed at the concave surface of said body being concaved to conform with and continue the cavity of the body surf-ace, said valve having a stem extending into and guided by said bore and one or more longitudinal grooves extending along said bore to define passage for fluid about the stem of said valve.

2. A pessary, comprising a unit including a 6 body member having a concave tissue engaging depression in one of its surfaces, a valve bore extend-ing through said body and communicating with said concave surface and having a valve seat formed therein adjacent said surface, a valve member having a stem extending through said bore and adapted to seat upon said valve seat, the surface of said valve exposed at the concave surface of said body being concaved to conform with and continue the cavity of the body surface, said valve having a stem extending into and guided by said bore, one or more longitudinal grooves extending along with bore to define passage for fluid about the stem of said valve, and a lug on the stem of said valve projecting into said groove to resist rotary motion between said valve and said body.

3. In a pessary and manipulating handle assembly the combination of a pessary unit, including a body member having an inner surf-ace adapted to engage and press upon the uterus, a valve bore extending through said body member away from said surface and having a valve seat formed therein adjacent said surface, a valve member adapted to seat upon said surface and having a stem extending through said bore, said stem having coupling means thereon at the end thereof remote from said surface, a manipulating handle including coupling means engageable with the coupling means on said stem to positively connect the manipulating handle with said valve stem, said body having means defining a fluid passage parallel to said valve stem and said handle having a fluid passage extending there- 'through and communicating with the fluid Passage in said body.

4. In a pessary and manipulating assembly the combination of a pessary unit, including a body member having an inner surface adapted to engage and press upon the uterus, a valve bore extending through said body member away from said surface and having a valve seat formed therein adjacent said surface, a valve member adapted to seat upon said surface and having a stem extending through said bore, said stem having coupling means thereon at the end thereof re mote from said surface, a manipulating handle including coupling means engageable with the coupling means on said stem to positively connect the manipulating handle with said valve stem, said body having means defining a fluid passage parallel to said valve stem and said handle having a fluid passage extending therethrough and com-- municating with the fluid passage in said body, and means for interengaging said handle and said body when said handle has moved said valve to open position for sealing said .stem and said body together to prevent escape of fluid except through said fluid passages.

5. In a pessary and manipulating assembly the combination of a pessary unit, including a body member having an inner surface adapted to engage and press upon the uterus, a valve bore extending through said body member away from said surface and having a valve seat formed therein adjacent said surface, a valve member adapted to seat upon said surface and having a stem extending through said bore, said stem having coupling means thereon at the end thereof remote from said surface, a manipulating handle including coupling means engageable with the coupling means on said stem to positively connect the manipulating handle with said valve stem, said body having means defining a fluid passage parallel to said valve stem and said handle having a fluid passage extending therethrough and com- REFERENCES .CITED The follawing references are of record in the file [of this patent:

PSEIATES PATENTS Number Number Name Date Sherwood Sept.23, 1890 "Beck Aug; 25, 1908 Ni-mmer Mar. 24, 1925 Hudgins Jan. 1, 1946 FOREIGN PATENTS Country Date Germany Feb. 11, 1913' 

